5 - Integrating Articulation Therapy in Clinical Practice

Toye Oyelese

Welcome back, everyone. Hard to believe we’ve made it to the last episode of this clinician series—after weaving through the theory, the mechanisms, clinical steps, and quite a bit about when not to use articulation therapy... well, now it’s time to get practical. I know many of you have been waiting for the nitty-gritty: Where does this actually fit in my sessions? How do you fold it in without upending everything else?

Toye Oyelese

So, a question I get a lot, both in person and by email: “When do you introduce this with a patient?” I’ll say, after an initial assessment—once it’s clear this patient might benefit and I have a pretty good sense of their landscape. I tend to set aside anywhere from 15 to 20 minutes, either as a block in their regular session, or sometimes as its own thing if we need the space. The conversation sounds kind of like: “Based on what you’ve shared, I think there’s an approach that might help. It’s not rooted in analysis or deep cognitive work—it’s very task-based, more like an exercise than a discussion. Would it be okay if I explain and we see if it fits for you?” And then I triple-check that I haven’t butchered the explanation, as usual.

Toye Oyelese

The spirit of it is, it’s an option. You’re not mandating a new religion; you’re offering a tool. Some folks, especially those burnt out from being told what to do, appreciate that flexibility. It’s more... “Let’s see if this resonates,” and less “Let’s do this or else.”

Toye Oyelese

The follow-up’s actually lighter—so, once the patient’s got their articulation, you’re revisiting the practice in, say, three to five minutes per session. I ask: Are you doing the repetitions? How consistent are they? How’s your confidence with the phrase? Conviction still high? And then—does the language still fit, or has life changed in a way that suggests some tweaking?

Toye Oyelese

Here’s something important: you don’t have to dump your old methods for this. In fact, it layers beautifully. If you do CBT—articulation plugs into restructuring nicely. While CBT finds and challenges the faulty thoughts, the articulation, with enough repetition, plants the new ones. Supportive therapy? Now they’ve got homework. Brief interventions? You can prescribe an articulation in a single visit and just catch up by phone.

Toye Oyelese

And if there’s medication involved—think of this as working on the psychological direction, while the meds handle the chemistry. It’s a both-and, not an either-or. I’m making it sound smooth, but sometimes it’s still a juggle, especially when you’re crunched for time or negotiating what fits into one precious session, but I’ve seen it work even in small doses.

Toye Oyelese

Now, once you’ve introduced it, the next question is: How does this fit over the whole arc of care? I like to break it into phases—the acute, the stabilization, and the maintenance.

Toye Oyelese

In the acute phase, think crisis. Severe symptoms, lots of distress, maybe an adjustment disorder right after a layoff, maybe someone swirling in panic. Here, articulation is all about stabilization—it’s a lifeline. The phrase itself should be basic and survival-oriented, and the “dosage,” if you can call it that, is high. We’re talking: “I will survive. I will get through this.” Repetition is the name of the game here. You’re giving them something to hang on to, not expecting some big insight.

Toye Oyelese

The follow-up, naturally, is closer together—weekly or even more if you sense things are still shifting fast.

Toye Oyelese

As symptoms settle, the protocol evolves. What started as survival—“I will get through this”—can shift to “I will build something better.” The language turns toward growth; the repetitions taper down. At this stabilization point, some folks find themselves able to re-engage with other therapeutic work—insight, reflection, broader goals. The articulation, meanwhile, shrinks from firehose to gentle drizzle.

Toye Oyelese

And then, maintenance—well, that’s more like exercise. You’re not pushing the limits, but you’re keeping the wiring active. Some patients keep up the practice for months, even years, dialing up the frequency when life gets rocky, tapering off when things are smooth. There isn’t a compulsory “graduation day”—the idea is that it’s available for whenever you need it, sort of like your favorite lucky charm or worn-out adage.

Toye Oyelese

I do remind patients: Don’t be afraid to return to a more intense practice if things get tough again. It’s not a sign of failure—it’s what the tool is for. And I always keep an open door for folks whose needs oscillate—sometimes they come back for a tune-up, sometimes they’ve outgrown it. That’s life.

Toye Oyelese

Let’s bring this to life—now, these are composite cases, not individual patients, but the patterns are real. The first, I call the “over-insighted anxiety sufferer.” Picture a middle-aged professional—years of therapy, can outline every cognitive distortion in their sleep, but still, the anxiety won’t budge. For her, insight had stopped moving the needle. So, I said, “You know, I don’t think more understanding is the answer. Want to try something you can do instead of dissect?” Together, we tried a few phrases—“I will trust,” “I will be accepting”—but they didn’t stick. Finally, she landed on: “I will trust the process. I will let go.” Daily, mindless, 10 by 10 reps. After about a month, her confidence was way up—anxiety still there at times, but it didn’t spiral. By three months, she called the articulation a “reset button.”

Toye Oyelese

The next case is acute adjustment disorder—a man reeling after losing his job, no psychiatric history, but suddenly drowning in shame and worry. Initial attempts at “I will be successful” felt hollow—too tied to his job title. Eventually, after teasing out what really mattered, he picked: “I will rise. I will provide. I will be stronger for this.” Twice the usual dose—20 by 10—and a side of low-dose SSRI. Some tough days, but we problem-solved with routines; he anchored the repetitions to things he’d never skip—morning coffee, evening shower. Six weeks later: mood up, actively job searching, and that articulation was his shield against demoralization. By the three-month mark, he’d landed a new role and, in his words, “rewired” how he handled setbacks.

Toye Oyelese

Third, performance anxiety—this time, a resident physician. Not a disorder, per se, just freezing up in high-pressure moments: codes, tricky conversations. She knew she was capable, but just couldn’t access it when it mattered. Her articulation was a hybrid: “I will be present and clear. I am capable.” The “I am capable” part was key for her—not about doubt, but about embodying presence. She used the articulation like a pre-game ritual before rounds, before any difficult encounter. Her freezing response started to dissolve, and she stuck with the practice right through residency.

Toye Oyelese

Now, quick clinic tips? Confidence and conviction checks, every time. Honestly, it’s like traffic lights—green means go, yellow means it’s time to rethink. And always fit the articulation to the moment. Survival words in crisis, growth words in recovery, and don’t be afraid to revise.

Toye Oyelese

I’d be remiss not to mention my own use of this. During my time building up Westside Medical—if you’ve heard me in past episodes, you’ll know—it was brutal. I survived by repeating to myself, probably hundreds of times a day, “I will survive, I will thrive.” Wasn’t solving the admin headaches, but it kept me in the fight long enough to sort them out. After years, it stopped being something I forced; it just became how I talked to myself under pressure. I also learned you can’t skip the volume—a few repetitions here and there don’t cut it when things are tough, and, oddly, the less I analyzed it, the better it worked. Sometimes you just trust the rain, don’t try to dissect every drop.

Toye Oyelese

So, that’s my wish for you as you try this approach. It’s not replacing insight or old-school therapy, but, for stuckness—when patients have done all the understanding in the world, and change just isn’t happening—it’s a way forward. Thoughtful use, ethical boundaries, and that spirit of experimentation. And if you’ve got that one impossible case, maybe this is the nudge where everything else has stalled.

Toye Oyelese

Thanks for joining me through the Mindlessness Clinician Series. If you want more, the general series is out there for your patients. I’ve also put together The Rules Framework—therulesframework.com—for decision-making under uncertainty. It’s free, and it might help you or your clients trying to navigate the messiness of choice. I’m Dr. Toye Oyelese, grateful as ever for the privilege of sharing this with you—and, well, here’s to surviving and thriving together. See you out there.